Management of Anemia in CKD: A Review

Chronic Kidney Disease leads to progressive failure to the kidney. If untreated, a number of complications may arise such as anemia, hyperlipidemia, cardiovascular disease. Renal anemia is highly prevalent in CKD patients (both in dialysis and nondialysis). Anemia can be managed by using either Erythropoietin Stimulating Agent (ESA) or by IV iron therapy. Recombinant human erythropoietin (rHuEPO) is widely used ESA to treat anemia. Hemoglobin (Hb) variation can be controlled by using these agents. The IV iron therapy is also considered a standard care in anemia management because it can reduce the exposure to ESA. Anemia contributes to increases morbidity, mortality and poor quality of life. Treating anemia mainly in dialysis patients with ESA reduces the risk of blood transfusion and increase the patient quality of life. This is because it can cause either hyporesponsivenes or erythropoietin resistance. Another recently discovered drug Roxadustat is a promising therapeutic approach against anemia in CKD. The hemoglobin response of roxadustat is independent of inflammatory microenvironment.